OBAMACARE EQUATION — Four million down. Two million to go. Five weeks to get it done. That’s Obamacare enrollment in a nutshell, our editor Joanne Kenen writes. “The administration wants to boost those numbers to around 6 million before open enrollment season ends March 31. A strong March finish helps the White House put that rocky October rollout firmly behind it, give the health plans the customers needed to make the new insurance markets work and head toward the November midterms with some stories of success.”

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…“Still, stronger sign-up totals won’t tell the whole story. It will be weeks or months before we know how many people who signed up actually paid their premiums, how many are newly insured, how many are young, how many quickly start to run up big medical bills and, perhaps most important for the law’s long-term sustainability, how many Americans actually end up reasonably happy with their coverage.” http://politico.pro/1hhQph4

--Josh Earnest, principal deputy White House press secretary, told reporters yesterday to direct their questions about who’s paid their premiums to private insurers themselves. “As you know, the Affordable Care Act is a reform of our private health insurance system…questions about who exactly has paid for the health insurance can best be directed to those private insurance companies,” he said.

FIX HEALTHCARE.GOV, HERE’S $14 MILLION — Federal officials rushed $14 million to Obamacare contractor Verizon Terremark as part of its frenzied push to get the crashing website working by the end of November, according to a contract modification posted on a federal website last week. That explains why CMS hurried to pay the company more money rather than participate in the competitive bidding process that federal law normally requires, Pro’s Kyle Cheney reports. http://politico.pro/1fItNWh

ENROLLMENT DAYS REMAINING: 33

Welcome to Thursday morning, PULSE readers. When lawmakers wrote the ACA requirement that plans must now cover eyeglasses, they must have been thinking of Pro Health reporters and our uncomfortably dry contacts after a day of staring intensely at the computer screen. Hang in there along with me — we’re just two days away from the weekend. Always reachable at pcunningham@politico.com.

“Wanna whole lotta PULSE.”

CAMP TAX PLAN’S OUT — The Ways and Means chairman released his long-awaited tax plan yesterday, giving your PULSEr the thrilling afternoon activity of combing through it for health-related provisions. And there are some biggish ones, especially related to the Affordable Care Act. It would repeal the law’s medical device tax and its “medicine cabinet tax,” which prohibits health spending accounts from being used to buy most over-the-counter medicines. It would also repeal an Obamacare tax credit for small employers and a tax exemption for health insurance co-ops.

--Unrelated to the ACA, the plan would authorize Treasury to levy up to 100 percent of a payment to a Medicare provider for unpaid taxes, instead of just 15 percent. And it would ditch the tax credit for orphan drugs. The plan: http://1.usa.gov/1c8JPd8 And a summary which will still make your head hurt, but less: http://1.usa.gov/1hpq8wG

--The plan could give Democrats fodder this election year as it includes something to offend seemingly everyone, Pro Tax’s Brian Faler reports. Camp emphasizes that it will give taxpayers a simpler, fairer code — but on the political side of things it will likely leave many Republicans fighting off complaints that they’re targeting scores of popular tax breaks. http://politico.pro/Mv1Dml

ICYMI — Yesterday, five Senate Democrats with no upcoming reelections to worry about said they’ll start talking about Obamacare just as much as their Republican counterparts. They’re convinced that telling positive, real-life stories about the law will finally cause public opinion to start shifting. The Pro story: http://politico.pro/1hhP0ag

HILLARYCARE: ‘OBAMACARE ON STEROIDS’ — That’s what the Republican National Committee claimed yesterday in a memo attempting to link Hillary Clinton to Obamacare in her various roles as first lady, presidential candidate and secretary of state. Released the same day she addressed a health care industry conference in Florida, it brings up the health reform plan she pushed in the 1990’s and the policies she advocated while running for president in 2008. The memo: http://bit.ly/1hSYATD

** A message from AHCA. Skilled nursing has been tasked with a challenge: continue to improve quality care for millions of Americans and do so on razor-thin 1.8 percent margins. Even still, the long term and post-acute care profession continues to improve lives by delivering solutions for quality care. We are AHCA. And we are the solution. Learn more at ahcancal.org/solutions.**

HAPPENING TODAY...the Senate HELP Committee is expected to vote today on whether to approve the nomination of Vivek Murthy as U.S. surgeon general, after postponing a scheduled vote yesterday…the Senate tentatively plans a final vote on the Veterans Health and Benefits and Military Retirement Party Restoration Act of 2014.

…the House Energy and Commerce Health Subcommittee will markup four public health-related bills ( http://1.usa.gov/1cmnYJV).

…the House Appropriations Subcommittee on Commerce, Justice and Science will hear from John Holdren, director of the White House Office of Science and Technology Policy, about federal investments in neuroscience research ( http://1.usa.gov/1hUa0GU).

... Sen. Richard Burr and five conservative House Republicans are scheduled to discuss GOP health reform ideas at the National Press Club ( http://bit.ly/1evKvUe).

WHAT YOU MIGHT NOT GET IN O-CARE PLANS — Obamacare did little to change the services insurance plans tend not to cover, according to a study by HealthPocket. It found the top 10 most commonly excluded services include long-term care, cosmetic surgery, adult dental services, weight loss programs and acupuncture. Eighty percent of the services on the list were also typically uncovered in pre-Obamacare plans, the report says. But plans do include two previously-uncovered services that are now required: children’s dental coverage and eyeglasses. The report: http://bit.ly/1fUBqFG

ENROLL AMERICA’S FINAL PUSH — Yesterday the group kicked off its final push to sign up people for Obamacare by the end of March, announcing a campaign in the major cities of 11 states and a bus tour to start next month. Launched to bolster sign-ups, Enroll says it has reached out to more than 660,000 consumers since the fall. http://politico.pro/1fIuNd5

HEALTH SPENDING: A HISTORY — Sen. Tom Coburn (R-Ok.) has released an expose on federal health care spending and its steeply upward trajectory over the last 40-plus years. http://1.usa.gov/MvRwOa

PLANNED PARENTHOOD’S 2014 GAME PLAN — The group’s political arm is preparing to launch its largest campaign offensive ever, targeting more than a dozen states and some of the top Senate and gubernatorial races and expecting to spend more than $18 million. That would make PP’s political entities some of the heaviest outside spenders on the Democratic side. The group has rapidly become a vital part of election strategy among left-of-center groups, with Democrats increasingly reliant on their advantage with women voters. http://politi.co/NxWYAW

E-CIGARETTE MARKETING — Five Democratic senators have introduced legislation to ban e-cigarette manufacturers from targeting children and teens in their marketing. Surveys show that in 2012, 1.8 million middle and high school students tried the increasingly-popular cigarettes, which are battery-operated and convert liquid containing nicotine into a vapor. They fall outside of the federal laws and regulations governing regular cigarettes. “With fruit and candy flavors and glossy celebrity ads, e-cigarettes makers are undeniably targeting young people. Unfortunately, it’s working,” said Sen. Dick Durbin (D-Ill.).

PUSHBACK ON PROTECT ACT — A coalition of medical device makers, software developers and healthcare providers are sounding the alarm on a bill introduced in the Senate this month meant to protect some medical tools from FDA oversight. But the mHealth Regulatory Coalition warns that the bill wouldn’t just give a pass to the health and wellness apps that the FDA has already said it has no intention to review. It would also deregulate devices intended to diagnose melanomas, for instance, and applications meant to notify nurses quickly that a patient’s health is deteriorating, the group said. http://politico.pro/1mCK15h

CARE FOR CHILDREN — Spending on health care for children is growing faster than overall health spending, a new report by the Health Care Cost Institute finds. Babies and toddlers accounted for the most spending of any age group, largely driven by doctor visits and hospital care for the sickest newborns. Other findings include: spending is growing faster for boys than girls under age 13, use of drugs for conditions like anxiety, depression and ADHD is rising and there’s an increase in teen mental health admissions.

WHAT WE’RE READING, By Jennifer Haberkorn

The Obama administration will propose boosting the National Health Service Corps from 8,900 people per year to 15,000 per year over the next five years and moer than $5 billion to train primary care residents, USA Today reports. http://usat.ly/1kb75tF

Enrollment in the health law's new co-ops are mixed so far, with some programs reporting stronger results than others, the New York Times reports. About 300,000 of the 4 million enrollments have been in co-op plans. http://nyti.ms/1fsZO03

Some Republicans caution against the party focusing only on Obamacare in the midterm elections, Karen Tumulty writes in The Washington Post. http://wapo.st/1enV4xe

Harry Reid on Wednesday said that "all" of the Obamacare horror stories are untrue — a point that Republicans blasted him on. This report from The Washington Post http://wapo.st/1o7N18L

** The skilled nursing and assisted living profession is not a bystander in the budget debate. Our long term and post-acute care providers know that smart policies result in better care and more balanced budgets. With operating margins teetering dangerously at 1.8 percent, we know that actions must take the place of rhetoric. Our profession is offering solutions to issues that make a difference in patients’ lives and Medicare’s budget, such as reducing hospital readmissions, improving patient outcomes and increasing quality care in America’s skilled nursing and post-acute care centers. But these solutions are just the beginning. We are AHCA and NCAL. And we are the solution. Learn more at ahcancal.org/solutions. **

Authors:

About The Author

Paige Winfield Cunningham is a health care reporter for POLITICO Pro and co-author of the morning newsletter Pulse. Previously she reported for The Washington Times’ political team, covering elections, Congress and health policy, including the 2012 Supreme Court ruling on the Affordable Care Act.

Cunningham grew up in St. Louis and attended college in the Chicago area, graduating from Wheaton College in 2006. She spent most of her time at the Wheaton Record, where she served as features editor, but made sure she still had time for playing violin in the conservatory orchestra.

Cunningham covered county government for the Naperville Sun right out of college, but when the paper filed for bankruptcy, she decided it was time to move on. She moved to the D.C. area in 2009 to report on Virginia government and currently lives in that state with her husband.